St. Matthew Lutheran Church of Westfield
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VBS Registration 2019
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Indicates required field
Student's Name
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First
Last
Age
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Gender
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Male
Female
Grade entering this Fall
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Home Church (if applicable)
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Pastor's Name (if applicable)
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Allergies, Medical Issues or Special Needs
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Parent Name(s)
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number
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Cell Phone Number
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Email
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Emergency Contact
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First
Last
Emergency Phone Number
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Alternate Pickup Name
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First
Last
Alternate Pickup Phone Number
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How did you hear about this VBS?
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Family/Friend/Neighbor
Signs
Subdivision Newsletter
Posters/Bulletin Boards
My Church Bulletin
Facebook
St. Matthew's Church Website
Medical Release
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I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.
General Information or Other Comments
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Photo Release
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I hereby grant the above named church permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.
By clicking "Submit" below, I give permission for my child (named above) to attend the Vacation Bible School (VBS) listed above. I understand that the information I give for this registration will only be used by the VBS hosting church, and that all registration information except for email address for next year's VBS reminder will be removed from the hosting site by December 31 of this year.
Submit
Home
History
What We Believe
Pastor's Page
Hispanic Ministries
Divine Services
Church Activities
Giving
Sunday Bulletins
Monthly Newsletters
Special Announcements
Contact Us